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Art therapy from the perspective of management and quality sciences

Jan Fazlagić

Abstract

Art therapy is a field of activity with both practical and theoretical foundations although the latter are not precisely defined. Management and quality sciences, as well as economics, include management in the healthcare sector as one of their areas of interest. Despite a wealth of literature on the subject of management in healthcare, no in-depth research on art therapy as a specific form of delivery of the therapeutic process has been conducted so far. The aim of this article is to identify potential areas for further interdisciplinary research linking the field of management and quality with health sciences and education sciences (bearing in mind that art therapy is not a separate, autonomous scientific discipline). In order to achieve this we conducted a comparative analysis of selected concepts of management and quality sciences with the scope of the subject matter of art therapy, and as a qualitative method of literature review we chose the deductive method. The outcome of the study is the development of a proposed set of areas for further interdisciplinary research linking management and quality sciences with the sciences that include art therapy. The research findings presented here highlight numerous areas of overlap between art therapy and management and quality sciences, which hold potential for application in art therapy practice and theory.

Keywords: art therapy, interdisciplinary research, management and quality sciences, integration of research agenda, creativity

Introduction

Art therapy is a form of psychotherapy that seeks to help clients experiencing adverse circumstances, illness or disability, addressing a person's social, emotional and mental needs. Management and quality sciences, on the other hand, are the disciplines of science concerned with establishing relationships between situations and the ways in which people behave at work, and their performance, providing recommendations designed to ensure maximum efficiency of individual and team performance. From a theoretical perspective, the specificity of art therapy lies in the fact that it is somewhat 'torn' between educational sciences, health sciences and psychology. Both management and quality sciences and art therapy share a common denominator - they belong to the field of social sciences, i.e. sciences that study the structure and functions over the history of a society, its culture, laws and the patterns of its development.

This paper discusses selected concepts that make up the body of knowledge in management and quality sciences in the context of their use within art therapy practice and theory, with the aim of filling the gap and encouraging both management and art therapy theorists and practitioners to integrate research and explore common research areas. The utilitarian purpose of this paper is to inform the art therapy community of the achievements of researchers in management and quality sciences, and to encourage art therapists to broaden their research interests beyond the literature in art therapy and psychology. This approach is not unprecedented: in management and quality sciences, there is extensive use of knowledge from psychology, cultural anthropology, neuroscience, sociology, etc., which only proves that management and quality sciences are inclusive sciences - sciences that draw inspiration and use research results from outside the hermetically defined boundaries of this scientific discipline. It seems reasonable that art therapists, following in the footsteps of management science theorists and practitioners, should also become more involved than they have been to date in using research findings from management and quality sciences. According to the author, this is to strengthen the further development of art therapy, both in the area of practice and theory, as well as in strengthening the argument for art therapy to become an independent scientific discipline, as postulated by many researchers, including the recently deceased Professor Wita Szulc, a precursor of Polish art therapy (see: Szulc, 2010; Szulc, 2014).

Management sciences are classified as social sciences, since they involve the actions of people - P. F. Drucker puts it more precisely: "Social sciences, including management, are concerned with the behaviour of people and the institutions created by people" (Sudoł, 2022). There is no doubt that in management sciences the object of analysis is the organisation, whereas in art therapy the activities of the art therapist concern the individual. However, if we look deeper into the field of interest of management (and quality) sciences we discover that within this discipline there are studies and analyses concerning the interaction of individuals with organisations, including: employee creativity, innovation, knowledge management, employee motivation, work-life balance and many others. The research scope of management and quality sciences is concerned with making work (individual and team) in organisations as efficient as possible. On the other hand, from the perspective of management and quality sciences, the postulate of art therapy effectiveness is the achievement of therapeutic goals by the client. At the same time, it is worth mentioning that management and quality sciences take as their area of interest not only a collective, team or group, but also the individual in the organisation. Moreover, in management and quality sciences there are many studies regarding the interaction of individuals (rather than groups), e.g. between team leaders with team members, between colleagues within a team, members of an organisation and its external stakeholders, etc. In all these cases, knowledge of the human subject, deeply humanistic knowledge, is applied. In contrast to economics, management and quality sciences - like art therapy - make large-scale use of qualitative methods in scientific research.

Management and quality sciences and art therapy

Management and quality sciences is a scientific discipline in the field of:

  • economic sciences (e.g. Doctor of Economic Sciences in the field of management and quality sciences),
  • humanities (e.g. Doctor of Humanities in management sciences).

According to the earlier classification in Poland, management was the domain of economic sciences, hence this discipline was referred to as "organisation and management". Today, an interdisciplinary approach to management, especially the use of psychology and other social sciences and humanities, has resulted in a dichotomous approach to management sciences. Management sciences are classified as social sciences, i.e. sciences concerned with the study of the structure and function of the history of society, its culture, laws and the patterns of its development. In addition to natural sciences and humanities, they are classified as empirical sciences. These sciences deal with society and social phenomena and processes viewed from different perspectives (e.g. sociology, social psychology, ethnography, law, political science, or management, to name but a few).

Management and quality sciences can provide art therapists with a wide range of concepts and research methods that have not yet been explored as worthy of being used in therapy. These include issues related to the management of the therapeutic service delivery process, service design, and also the use of knowledge of leadership in therapeutic work. As Wita Szulc (Szulc, 1993) notes, the term 'culture' etymologically derives from the classical antiquity, and the Latin word cultura originally meant the cultivation of farmland. In the intellectual sense, it was first used by Cicero in his philosophical writings when he introduced the phrase cultura animi, which literally means 'cultivation of the mind'. Psychology treats culture as a set, which includes above all an individual's behaviour, thoughts, feelings and reactions from the perspective of psychology as a set of rules and behavioural motives, forms of expression, set of orders and forms of positive and negative expressions, as well as assessments and judgements. From the perspective of sociology, on the other hand, culture is a certain separable aspect of the life and activity of human society, which is connected with the sphere of needs and experiences of a non-direct nature (Szulc, 1993, p. 15). The term 'therapy' in Polish means a treatment or a therapeutic method. In classical Greek, the word refers to nurturing, because it means caring for someone, taking care of someone, and only in the third place - to engage in healing. The Greek therapeutés, or therapist, means one "who cares for someone, takes care of someone" (Szulc, 1993, pp. 16-17). Incidentally, this classic definition brings the figure of the art therapist closer to the defining figure of a good leader (of an organisation) within the concept of servant leadership (Sendjaya & Sarros, 2002): "I serve because I am the leader, and I am the leader because I serve" (more on this in Table 1).

Wita Szulc defines art therapy as "the spontaneous creativity of patients, under the care of therapists, or the creative activities undertaken in a therapeutic situation by people previously non-creative in the visual arts" (Szulc, 2005, pp. 17-18). Rudowski (2009) considers art therapy to include the totality of artistic and aesthetic activities undertaken in a very wide range of settings (procedures) of psycho-socio-pedagogical methods focused on the healing of a patient or client, whereas in English-language literature art therapy is increasingly referred to as art-psychotherapy, and is understood as the use of artistic means to express and work through the difficulties with which the client comes to therapy (Bogus, 2015). The specificity of art therapy is that it is in fact somehow "torn" between:

  1. Pedagogy - among other things, because educational pedagogical universities most often adopt this therapy in their curricula. The second reason is the utilitarian use of art therapy in education,
  2. Health sciences - therapeutic functions of art therapy place it among the health sciences, and art therapists often cooperate with doctors,
  3. Psychology - art therapy sometimes comes in a variety called: "psycho art therapy." Knowledge of the human psyche is crucial for art therapists, especially since, until recently, psychologists had no insight into the client's "interior" (in the literal sense of the word) - unlike doctors. The situation is currently changing thanks to the use of neuroscience research (see, for example King & Kaimal, 2019) to art therapy theory.

Wita Szulc (2010, p. 40) addressed the problem of the identity of art therapy as a scientific discipline that needs to establish its own research methods in order to develop and gain recognition in the world of medical therapy. She also draws attention to the differences between "making the stay of patients in hospitals more pleasant "and actual art therapy activities. According to Andrea Gilroy (see: Szulc, 2010, p. 41) art therapy fulfils the criteria of the definition of science, because it meets all the conditions, that is it represents a certain state of knowledge, it is a department of systematised knowledge, and it is something that can be studied and learned as systematised knowledge.

Art therapy in management and quality sciences

In order to explore the possible links and relationships between art therapy and management and quality sciences, and the potential contribution that can be made by using the output of management and quality sciences in the theory and practice of art therapy, the most important ones were reviewed, according to the author of the concept, that is ones often found in the literature of management and quality sciences, as well as economics (e.g. creative sectors, creative economy). The scientific problem, for which a solution was sought, was to discover the links between art therapy (both in practical and theoretical terms). A deductive approach was used, whereby:

  1. The variables were defined, and are selected concepts from management and quality sciences,
  2. Relationships and connections were sought,
  3. Postulates (theses) were formulated regarding possible future interdisciplinary research and conceptual relationships.

Table 1 shows the results of this search. On the basis of the respective bodies of knowledge with regard to each of the concepts listed in the table, an attempt was made to indicate how the concept could be used for scientific research on the management of the art therapy process. These concepts seem particularly closely linked to the theory, and in some cases the practice, of art therapy. The presented overview does not exclude the possibility of expanding the list to include some other concepts. The author's intention when reviewing these concepts was not to exhaust the topic, but rather open up a new avenue of research, and present the community and therapists with potential for further exploring on their own. The research approach proposed here by the author is intended as a way of promoting a multidisciplinary approach to science, which, it seems, will be essential in the age of artificial intelligence, as AI does still not have the capacity to embrace reality as holistically as humans (for more on this, see, among others: Harari, 2018). As such, the multidisciplinary approach, which is closely linked to human creativity, is also an opportunity to maintain human superiority over artificial intelligence in the field of scientific research in the broadest sense.

Table 1

Common areas and links between management and quality sciences and art therapy

Concept within management and quality sciences Art therapy reference: keywords + description
Postulates (theses) concerning potential future interdisciplinary research and conceptual relationships
Creativity

Creativity, expression of creativity, domains of creativity, the profession of a therapist as a creative profession, art therapy services as part of the creative sectors

According to the OECD (2019), creativity is the competence of efficiently generating, evaluating and refining ideas that can result in original and effective solutions, knowledge development and an impact on imagination. This definition emphasises the importance of involvement, i.e. the expenditure of energy on the part of the learner to carry out the creative process, and the value of this process is measured by the originality and relevance of the solutions created to the issue at hand. It is difficult to imagine a good therapist who is not gifted with an increase increased level of creativity. As a consequence, the application of knowledge on creative processes can be introduced to the training programmes for art therapists.

Most definitions of art therapy include a component indicating the client's involvement in the creative process. Obviously, these definitions refer to the role of art in the client's/patient's life.

Above all, art shows us an image of a certain concrete external reality of human life [...]. Thanks to art, the world of the most ordinary daily feelings and experiences is shown in deeper and multiplied dimensions. Simple actions or events acquire a new meaning through the prism of art, and become more objectified and generalised, and a process of human enrichment takes place thanks to what is most human. (Szulc, 1988, p. 39)

A better understanding of the mechanisms explaining creativity is therefore absolutely essential for every art therapist. Although art therapy is not about enhancing a person's creativity, it is worth knowing what the client's creative reserves are, especially taking into account Baer's theory (Baer, 1991), which states that people are characterised not so much by creativity in the general sense, but by so-called domain-specific creativity. If an art therapist fails to recognise these domains, then the whole effort of the art therapy concept may be lost, because they will engage the 'wrong' domain of the client's creativity in the process (see also Fazlagić, 2015). Wita Szulc (Szulc, 2018, p. 25) draws attention to creative therapies as other specialised forms of art therapy, alongside visual arts.

While management and quality sciences focus on the functioning of individual organisations, the interest of economics is in larger social organisations, such as countries or regions. Interestingly, here too we can find links with art therapy, as well as a bridge between this therapy and economics is the concept of creative sectors (more on this in: (Fazlagić & Skikiewicz, 2019; Fazlagić & Szczepankiewicz, 2020). Creative sectors are those sectors of the economy that employ creative workers in companies and other organisations that create added value through the sale of creative products and services, for example computer games, artistic events, graphic design services, media and advertising services, entertainment, etc. From the point of view of the classification of occupations, the profession of an art therapy would certainly have to be classified as a creative occupation, with art therapy belonging to the so-called 'creative class' (Florida, 2012).

Bartel (2017, p. 32) draws attention to the relationship between creativity and illness, an issue that is often addressed in studies on the biographies of outstandingly creative people. It is generally known that many outstandingly creative people experienced illness in their childhood. In this sense, creativity is linked to medicine - it enters, willy-nilly, into the field of interest of art therapy.

Motivation and personal development

Motivation, personal goals, emotions, needs, desires, personal development, quality of life

Expertise in motivation theories comes primarily from psychology, but management sciences draw abundantly on the research findings of psychologists, using this knowledge to develop effective management systems. Personal development is linked, on the one hand, to the issue of self-motivation, and, on the other hand, to employee development in organisations (employee burn-out, employee development, leadership development). Art therapy also aims to ensure the well-being of an individual using techniques that motivate the client towards self-development, enabling activation of the patient's (client's) potential. The difference between therapeutic actions and employee motivation largely comes down to the differences between the contexts of intervention. In management, the aim of an intervention targeting an employee is to increase the performance of the organisation in the broadest sense (and the game of increasing the well-being of the organisation and the well-being of the employee is not a zero-sum game), while in therapy, the aim of an art therapy intervention is to reduce or eliminate physical and/or psychological suffering. However, even then it is not a sharp distinction, as negative phenomena such as bullying, chronic conflict and job burnout are common problems in organisations. In such cases, interventions by the employer towards affected employees may be indistinguishable from therapy. At the same time, it must be understood that employee wellbeing is not an end in itself, but a means to achieving results for the organisation that employs them.

Work-Life Balance (WLB)

Culture, flexibility, well-being, quality of life

The object of the culture of therapy is a person who wants to be healthy and expects help in achieving this goal (Szulc, 2011, p. 25). This means that the techniques and interventions developed in art therapy do not necessarily have to be limited to the field of health care and support for those who are ill. Wita Szulc (Szulc, 2005, p. 54) writes of "health as a performance"; where "becoming healthy" is a creative act in itself, i.e. a performance, a presentation. Music therapy is one such activity that contributes to the quality of life, of which health is one of the conditions.

From the perspective of an employee in an organisation Work-Life Balance is the state where an individual achieves a balance between work and their private life. From the employer's perspective, the term covers various types of measures aimed at increasing job satisfaction. These measures are based on the assumption that employees who are too absorbed in their work are less productive than those who have found a balance between their personal lives and their work. The concept is also based on a generational shift in the labour market: employees of generations Y and Z are less likely to make sacrifices for their employer and advance their careers at all costs. As a result, retaining young people is a challenge due to their lack of interest in pursuing successful careers in organisations at the expense of personal freedom. Various types of therapeutic techniques, especially those linked to positive psychology, can be successfully used in WLB programmes (see among others Carlson & Kacmar, 2000; Hirschi et al., 2019; Michel et al., 2014).

Leadership

Leading, giving meaning and sense to cooperation, setting direction, giving hope

Leadership issues obviously occupy a central position in management and quality sciences. Research on the subject of leadership is, on the one hand, concerned with the accurate definition of effective leadership and, on the other hand, with methods for developing leadership competences among leaders in organisations. Many researchers are preoccupied with the idea of discovering a "golden set" of leadership behaviours guaranteeing that organisations achieve their intended outcomes. The considerable number of different types of leadership theories should encourage art therapists to reflect on the ways in which they conduct therapy.

Leadership theories explain how and why certain individuals become leaders. The role of the art therapist can be compared to that of a leader in a process involving another person. As with leading a human team, the art therapist can also potentially take different strategies to build relationships and achieve (therapeutic) goals. Situational leadership theories may be of particular interest from the perspective of art therapy theory and practice. In the literature on art therapy, there is much discussion of the competences of the art therapist and the standards for teaching art therapy. Also in leadership theories can we find theories that focus on the traits of the leader (traits approach) and their skills (skills approach). Therapists should also be interested in the concept of various leadership styles (style approach), or the situational approach, and theories of effective matching the leadership style to the situation (contingency theory), oriented towards motivating subordinates (path-goal theory), and the interactions between the leader and subordinates (leader-member exchange theory) (see for example Northouse, 2013).

Interpersonal communication

Interacting with the environment, exchanging meanings, interpersonal communication, dialogue

There is an abundance of literature on interpersonal communication (Communication Studies), including communication in organisations (see for example Guerrero et al., 2014; Knapp et al., 2014; Littlejohn & Foss, 2008). Here it is worth mentioning, among others, the communication privacy management theory, which deals with the mechanisms for the reception and disclosure of private information (Petronio & Venetis, 2017). Another interesting theory is the Relational Dialectics Theory (RDT) (Baxter & Braithwaite, 2008), which deals with the creation of meaning in dialogue between competing discourses. Within this theory, discourse is understood as systems of meanings that are revealed during dialogue between people. In research on interpersonal communication, a prominent place is taken by the concepts of identity and cultural differences (Schnurr & Zayts, 2012). In the therapy process, the art therapist aims to gain a better understanding of the patient's identity. According to Anita Stefańska, art therapy is predestined to initiate the process of unveiling and reinforcing "I" of a thought of being of the entities in the relational space. It is based on and refers to, among other things, the ability to establish contact, to express and set clear boundaries, to provide a framework, and to be consistent and coherent as well as flexible, i.e. the essential communication competences necessary in social situations (Stefańska, 2015, p. 7).

Wita Szulc (Szulc, 2014, pp. 13-24) draws attention to such aspects of art therapy communication as identification, action, trust and clarity; art therapy is a form of face-to-face communication. In organisational management, on the other hand, researchers are concerned with describing the various formal and informal roles and identities of employees (Welbourne, 2012). Many management theories come from psychology. Nevertheless, management and quality sciences in some cases play the role of a mediator/populariser of psychology, as they seem to demonstrate the practical applications of scientific discoveries more often than is the case with psychology. Psychologists are interested in human beings in the general sense, whereas management sciences are interested in people within organisations, people solving social problems. This is well illustrated by the disclosure theory, which has its origins in psychology, but has many applications in management and quality sciences allowing for the explanation of employee behaviour in organisations (see, for example: Greene et al., 2006; Masaviru, 2016).

Service management and relationship marketing

Trust, relationship, joint value creation, exchange of values, co-creation of a "service product", management of experience

There is no doubt that art therapy is a service (possibly a 'service product') - a service that can be provided both as a public service (e.g. by a public hospital) and on a commercial basis (e.g. by a private art therapy practice). Art therapy services contribute to the broadly defined service sector, which is the largest of the three economic sectors, aside from the manufacturing and agriculture sectors (for more on this see Fazlagić, 2012). Relationship marketing is a development stage of marketing that emerged primarily for the management of service organisations, with a distinguishing feature being the focus on building a long-term relationship with the client. In relationship marketing, the completion of a transaction (sale) becomes secondary, and the creation of value for the customer becomes more important. Relationship marketing is all about high quality service, customer feedback, and regular communication with the customer (see, among others Grönroos, 1994; Rogoziński, 2012). In the literature on service management, a vital role is played by service design (see, for example: (Fazlagić, 2013) and experience design. Wita Szulc (Szulc, 1988, p. 40) refers to John Dewey, who treats art as an experience, and believes that a work of art has a unique quality, albeit a quality manifested in clarifying and focusing the meanings that the matter of other experiences contains in a diffuse and diluted way. Culture therapy is primarily focused on the feelings and emotions of the patient, which they are usually difficult to express directly. A similar approach can be found in the literature on service design (Stickdorn et al., 2018) and empathic design.

According to Anita Stefańska, art therapy is well-positioned to initiate a process of developing and reinforcing the subjects of relational space, based on and referring to, among other things, the ability to establish contact, express and set clear boundaries, provide a framework, be consistent and coherent, and be flexible, i.e. to the essential communication competences necessary in social situations (Stefańska 2015, p. 7).

Learning in an organisation and a learning organisation

Systemic thinking (seeing processes and their mutual relations rather than separate events), learning, team learning, personal mastery

The concept of a learning organisation was popularised by Peter Senge (1998), and is categorised as one of the leading management schools - namely system thinking school. Thanks to the work of Peter Senge, among others, management practitioners and theorists have recognised the crucial importance of learning processes for the development of organisations (Senge, 1998). In psychology, on the other hand, developmental theories and learning theories are distinguished (Rubin, 2001), as well as systemic therapies, which are directly linked to the concept of organisational learning, i.e. the employee's personal development and the therapy process can be described and explained using the same theories.

It is worth noting that the definition of therapy and that of learning are not significantly different. Learning is defined as a cognitive process leading to the modification of an individual's behaviour under the influence of experience, which usually increases that person's adaptation to the environment. Learning entails shaping the behaviour of an individual as a result of his/her previous experiences.

Source: author's own work.

Summary

The aim of this article was to identify possible areas for further interdisciplinary research linking the field of management and quality sciences with health sciences and education sciences (bearing in mind that art therapy is not a separate, autonomous scientific discipline). This was achieved by conducting a comparative analysis of selected concepts in the field of management and quality sciences, and then formulating conclusions in the form of postulates (theses) concerning possible future interdisciplinary research and conceptual relationships.

The use of the theories mentioned in this paper can contribute to the further development of art therapy practice and theory, enriching it with new perspectives, and research agenda and approaches. The aspirations of art therapists who seek the autonomy of art therapy among other social sciences are also important. The theories and research areas within the discipline of management science presented in this literature review represent only a "sample" of a wide range of research directions, and are intended to illustrate a wealth of knowledge that does not seem to be widely used in art therapy theory. Even if art therapist practitioners intuitively understand the theories mentioned, unconsciously applying them in practice, it is all the more worthwhile to make an effort to codify them within the framework of art therapy theory.

Such acknowledgment will certainly be easier if the authors of art therapy research make wider use of the achievements of other social science disciplines. The management and quality science concepts presented in the paper are the result of the author's subjective choice, and are certainly not exhaustive of the wide range of ideas that can be found in the literature. According to the author, rather than "exhausting the issue" it was more important to simply direct the attention of the research community to the discipline of management and quality sciences - using the example of a certain representative sample of concepts found in these sciences. There is no doubt that the comments in the table do not completely cover the issue, and it was certainly not the author's intention to create a closed list of concepts and at the same time exclude others from the scope of interest of researchers in the future. If this goal is achieved in the future and works further along the lines outlined here emerge, then this will certainly be beneficial to the development of art therapy in Poland and internationally, as postulated in the studies of Professor Wita Szulc.

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PL Arteterapia z perspektywy nauk o organizacji i zarządzaniu_Jan Fazlagić

INFORMACJE O AUTORZE

Jan Fazlagić

The author is a full-time professor at the Poznań University of Economics and Business in Poznań, Poland. A former Senior Fulbright Scholar at Sam Houston University (TX, USA) and Marie Curie Research Fellow at the Centre for Social Innovation in Vienna, Austria. European Commission Lead Expert in URBACT III programme. He is the author of over 300 books, research papers and popular media articles on knowledge management, intellectual capital, education and local governments. He has been involved in a number of projects supporting Polish public institutions including government agencies and ministries. His recent book is titled A Creativity-friendly school. Key Succes factors (Difin, 2023).

 

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DOI: https://doi.org/10.15219/em101.1630

W wersji drukowanej czasopisma artykuł znajduje się na s. 4-10.

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Fazlagić, J. (2023). Art therapy from the perspective of management and quality sciences. e-mentor, 4(101), 4-10. https://doi.org/10.15219/em100.1630

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